{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "PERFORMANCE REHAB INSTITUTE",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1646 WESTGATE CIR STE 106",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRENTWOOD",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37027-8563",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-465-6810",
"MailingAddressFaxNumber": "615-465-6817",
"FirstLinePracticeLocationAddress": "1646 WESTGATE CIR STE 106",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRENTWOOD",
"PracticeLocationAddressStateName": "TN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-465-6810",
"PracticeLocationAddressFaxNumber": "615-465-6817",
"EnumerationDate": "07/03/2014",
"LastUpdateDate": "04/01/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COLBERT",
"AuthorizedOfficialFirstName": "JOSHUA",
"AuthorizedOfficialMiddleName": "K.",
"AuthorizedOfficialTitle": "OWNER / PRESIDENT / PHYSICAL THERAP",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "615-519-9934",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "6507",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}